Team Effort: Dr Brian Koffman Describes Multidisciplinary Care for Patients With CLL

Brian Koffman, MDCM, DCFP, FCFP, DABFP, MSEd, of CLL Society, details the comprehensive multidisciplinary support for patients with chronic lymphocytic leukemia (CLL) at the European Hematology Association (EHA) 2024 Congress.

Brian Koffman, MDCM, DCFP, FCFP, DABFP, MSEd, executive vice president and chief medical officer of CLL Society, describes the multidisciplinary support that patients with chronic lymphocytic leukemia (CLL) receive.

He expanded upon this topic during his presentation, "Patient Reflections and Multidisciplinary Team Support," at the European Hematology Association (EHA) 2024 Congress; it took place during the session he chaired, "Empowering Patient Journeys: A Collaborative Expedition into Treatments and Emerging Frontiers in CLL."


Could you explain the multidisciplinary team approach to treating patients with CLL? Who is involved and how does it benefit patients?

CLL is, for most patients, an indolent chronic disease. As such, patients are often afforded the opportunity to build a team for their care, and that team has multiple parts to it.

On the professional side, there's often a local hematologist/oncologist caring for them. Infrequently, there's an expert, maybe at an academic center; sometimes those 2 people are the same, but sometimes those 2 people are consulting.

Sometimes there's other specialists. CLL patients are immunocompromised; they have a higher risk of second malignancies, they have higher risk of infection. So, their primary care provider, whether that's a family doctor, or a gynecologist, or something, has to be involved, making sure they're getting their appropriate vaccinations, their appropriate cancer screening that's age and genderspecific for the patients.

Above and beyond that, we know that approximately 40% of patients who are told that they have CLL, within the first month, have a mental health issue that requires medical intervention. They're seeing a doctor or a physician or other caregiver about this. So, sometimes mental health services have to be involved.

There can be tremendous financial stresses. Some of the treatments are extraordinarily expensive for patients—but there's ways around that. Above and beyond that, many of these therapeutic choices are not clear cut; they need sometimes to talk with other patients. We're very big at the CLL Society on offering support groups to patients, pee- to-peer counseling, even spiritual counseling, a chaplaincy service that we offer for free to patients to help them deal with that.

The most important piece for many patients is their caregivers. A lot of these therapies are difficult on the patient on their own, and without a caregiver to help guide the patient and be available to them, it makes these therapies almost impossible. So, there's a whole team that's put together for the patient to help them through this journey.

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